Contrast echocardiography can assess risk area and infarct size during coronary occlusion and reperfusion: experimental validation
S. téphane Lafitte, MD*,
Aya Higashiyama, MD*,
Hisashi Masugata, MD*,
Barry Peters, MD*,
Monet Strachan, RDCS*,
O. i Ling Kwan, RDCS* and
Anthony N. DeMaria, MD, FACC*,*
* Cardiovascular Division, University of California at San Diego, San Diego, California, USA
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Figure 1 Diagram summarizing FLASH and LATE sequence protocol performed during occlusion and reperfusion. MCE = myocardial contract echocardiography.
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Figure 2 Representative myocardial contrast echocardiography images and tissue sample delineating risk area and infarct size during occlusion (top) and reperfusion (middle). With occlusion, opacification defect was unchanged throughout FLASH and related best to risk area (RA), but smaller in LATE phase and related best to infarct area (IA). With reperfusion, BEGIN FLASH was larger and related best to RA, whereas END FLASH was similar to LATE images and best reflected IA.
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Figure 3 Correlations between risk area (RA) and infarct area (IA) sizes obtained by postmortem dye methods and FLASH sequence defects (beginning of the sequence, BEGIN) on the top panel and LATE sequence defects (LATE) during occlusion: RA is most closely correlated with BEGIN defect and IA most closely with LATE defect.
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Figure 4 Correlations between size of the infarct area (IA) and myocardial contrast echography (MCE) parameters from flash and late sequence.
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Figure 5 Correlations between risk area (RA) and infarct area (IA) sizes obtained by postmortem dye methods and FLASH sequence defects (beginning of the sequence, BEGIN, and end of the sequence, END, respectively) at four time points of reperfusion. MCE = myocardial contrast echocardiography.
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Figure 6 Variations of a and b parameters during each protocol phase: b = baseline, o = occlusion, r30, r60, r120, r180 = reperfusion 30, 60, 120 and 180 min. the evolution of the parameters differs for two subgroups defined by their infarct area sizes (*p < 0.01 for comparison for each group between basal and occlusion/reperfusion stages). MCE = myocardial contrast echocardiography.
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